CalOptima Rated Top Medi-Cal Plan in California
National Committee for Quality Assurance (NCQA) recognizes CalOptima’s overall quality for the fifth year in a row
ORANGE, California. (September 24, 2018) — For the fifth year in a row, CalOptima is California’s top-rated Medi-Cal plan, according to the NCQA’s Medicaid Health Insurance Plan Ratings 2018–2019. The NCQA ratings are based on standardized health care quality and customer satisfaction data.
CalOptima received a score of 4 out of 5 — the highest score awarded to any Medi-Cal plan in the state. In fact, only 13 Medicaid plans of the 177 reviewed nationwide scored higher. (In California, the Medicaid program is known as Medi-Cal.)
“At CalOptima, our members come first,” said Michael Schrader, Chief Executive Officer. “Our five-year record as the top plan in the state reflects the dedication of our outstanding local provider community to delivering the best health care outcomes for members.”
NCQA assesses Medicaid plan quality based on approximately 40 clinical measures related to both preventive care and treatments. Preventive measures report whether members get services to keep them healthy, such as well-child visits, immunizations and nutrition counseling. Treatment measures gauge whether members receive appropriate care in response to illnesses and chronic diseases, including diabetes and high blood pressure. NCQA also evaluates a plan based on nine customer satisfaction dimensions, such as getting care quickly and how well doctors communicate.
A county organized health system, CalOptima provides publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. In total, CalOptima serves nearly 780,000 members with a network of more than 8,000 primary care doctors and specialists, as well as 24 hospitals.
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS® is the most widely used performance measurement tool in health care. NCQA’s website (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.